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Home My WebLink About15714 (23)� �� `,y�� ---1� DEP�►RTMENT OF COMMUNITY&DEVELOP�ENT SERVICES ��f�� , � 21660 E.Copley Drive Suite 190 (909)86Q3195 Faa(909)861-3117 J U N 17 2002 JUN 17 ��: j PRESS ��'� � BUILDING PERMIT APPLICATION FIRMLY � � JOBSITE /� ]Z L�P/� D �N DATEICATION � 1 ' � NUMB R��I #/C. o ADDRESS '7 � 1 � ISSUE oi� TYPE OCC APN LOT TRACT DATE 1.'I I � V CONST. GROUP °C OWNER F OO ADDF�SS L ZONING SETBACKS Z CITY La� ZIP �TEL - FRONT RW ❑ g APPLICANT TEL�'"� REAR ❑ � _ SIDE/SIDE STREET RW ❑ � CONTRACTOR / �, SIDE ❑ Q ADD SS � CITY ZIP EL. PROPOSED USE o ARCH/ENG/ � DESIGNER NO.DWEL. NO. NO. CDDRESS Z�P TEL. UNITS � STORIES � BEDROOMS_�"�, � y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLARATION SFR/ADD/REM O � 1 HEHEBV AFFIRM UNDER PENALTY OF PERNRY THA71 AM EXEMPT FROM THE CONfRACTORS LI- G8f89B/C81p012 W CENSEUWFORTNEFOILOWINGREASON(SEC.7037.5BUSINESSANDPROFESSIONSCODE:ANYCITYOR (n U COUNTYWHICHHEOUIRESAPEHMRTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANYSTRUC� W P8fi0/DBCk � Z 7URE.VRpR TO ITS ISSUANCE,AL50 REW IHES THE APPLICANT FOR SUCH PERMIT TO FILE A SIC,NED W STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� W � CENSE LAW(CHA7TER Y(COMMENCINO WITH SEC7qN 7000)OF DIVISION 3 OF 7HE BUSINE55 AND PRO- � PooVSpa FESSpNSOODE)ORTHATHEORSHEISE7(EMPTTHEREFROMANDTHEBASISFORhiEALLEGE�EXEMP- (� TION.ANY VqLATION OF SECTION 7031.5 BY ANV APPUCAM FOR A PERMIT SUBJECTS THE APPUCANT T0 Z Re•Root � A CIVIL PEN�LTY OF NO7 MORE THAN FNE HUNDRED DOLURS(i500).j: . � ❑I,ASONRIEROFTHFppOPERTV,ORMYEMPLOVEESWITHWAGE5A57HEIRSOLECOMPENSA710N, � COrtlfflefClel � WILL DO THE WORK AND 7ME STRUCTUHE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70N,BU51• J � NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPEHTV 1N10 BUILDS OR�MPROVES THEREON.AND WHO DOES SUCH WORK HIMSELF OF HERSELF OR � THROUGHHISORHEROWNEMPLOVEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR m Q ,OFFEREDFORSALEIF,HOWEVER7HEBUILDINOORIMPROVEMEMISSOLDWITHINONEVEAROFCOMRE• Z �TION,7HE OMMER�BUILDER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE Oi SALE). � W ❑I,AS OWNER OF THE PROPEHTY,AM E7(CLUSIVELY CON7MCTINO W17H LICENSED ODMRACTORS � Q TO CON5TRUCT TIE PRQIECT(SEC.70u,BUSINESS AND PHOFESSIONS CODE:THE CONTRACTORS LI� V81U8fI0f1 ADJ.AAEA W CENSE UW OOES NOTAPPLY TOAN OWNER OFA PROPERTV WMO BUILDS Ofl IMPROVES THEHEOH,AND � VAIOCOMRACTSFOFSUq1PRQ1ECTSWI7HACONTMCTOR(S)LICENSEOPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE � Y TORS LICENSE UW.). ��/ Q ❑I AM El(EMGT UNOER SEC. B.8 P.C.FOR 7HIS REASON Q � �/�/ � 3 � P � os$ o Z DATE OYVNER � ' n �� w GL � LICENSED CONTRACTORS DECLARATION W � 1 HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT I AM LICENSED UNDER PHOVISIONS OF CHAPTEP � ) � {�A I � 0(COMMENCINO WITH SECTION 1000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND z �� XL� MY LICENSE IS IN NLL FORCE AND EFFECT. m �// � LLI _ G Slol7�{ ' 'w... � LICENSE CLASS G� �-/ LIC.NO, j V DATE II� ��- O� CONTRACTOR d �w 5 �� b WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PEN�LTV OF PERIURY ONE OF THE FOLLAWING DECURATIONS: � N a � _I HME NJD WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' 2 CONPENSATION,ASPROVIDEDBYSECTION370oOFTMELA00RCODE,FOR7HEPERFORMANCE U Q OF THE WORK FOR MMICH THIS PERMIT IS ISSUED. � � Qw _I HAVEMID WILLMAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION ...��yyy ' (�y\ 3700 OF THE LABOA CWE,FOR THE PERFORMANCE OF THE WORN FOR WHICH 7HIS PERMIT IS � �� (� r , � ISSUED.MY WORKERS'COMPENSATION INSURANCE C R�AND POIICY NUMBER ARE: CONSTRUCTION �i� jCARRIER E- F V r� PLAN REVIEW Z �icrr+uMaea — �0 �N � ELECTRIC ¢ � � (IFISSECfqNNFIDNOTBEOa.1PLETmOF7FEPEPMT6FORONEMRDfiED iro q� � PLUMBING ZI CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOF WHICH THIS PERMIT IS ISSUED,I MECHANICAL (�} SHALL NOT EMPLOY ANY PERSON IN Y MANNER SO AS 70 BECOME SUBJECT TO THE � WORKERS'COMPENSATIONLAWSOF ALIFORNIA,ANDAGR ETHATIFISHO LDBE ME INSPECTIONFEE S SU&IECT TO THE WORKERS'COMPEN ATION P VISIO S SECTION 37o F THE OR CO E,I SHALL FOR7NWIh1 COMPLY THO PROVI i ISSUANCE 1 O --1 a� p DATE: � '�O O APPLICAN. SMIP J w ENERGY P/C J WARNING FAILURE TO SECURE WORKERS'COMPENSATION CAVERAGE IS UNUWFUL,AND SHALL BE . � SUBJECTAN EMP�OYER TO CRIMINAL PENALTIES M1D CIVIL FINES UP TO ONE HUNDRED THOUSAN� ENERGY PERMIT DOLURS(i700,0001.IN ADDITION TO7HE COST OF COMPENSATqN,DAM�GES AS PROVIDED FOR IN J SECTpN 37oB OF THE LABOR CODE,INTEHEST,AND AT70RNEV'S FEES. � RETENTION FEE: � d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PERIUHV THAT THERE IS A CANSTRUCTION LENDING AGENCY d FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS ISSUED(SEC.7oe7,CIV.C.). - � • Z W � LENDER'S NAME � - 1_- LENDER'SADDRESS �/''� � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE 7HAT THE ABOVE INFORAIATION IS CORPECT. TOTAL F E ES �2 �L/�J w I AGREE TO COMPLV H7TH ALL CRY AND COUN7Y ORDINANCES AND STATE UWS RELATINO TO BUILDING � CONS7RUCTION,AND HEREBY AUT}iORIZE REPRESEN7A71VES OF THIS COUN7Y 70 EHfEN UPON THE � � ZABOVE�MEMIONED PROPERTY FOq INSPECTION PURPOSES. COMMENTS �� tLF�J✓z 1�.�-�^I� m PEiU11TTEE N E(Ppl " � IJ-1 `D� � SIGNATUREO ER EE OA7E ' = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finence Copy,PINK—Asseuor Capy,GOLDENROD--Fila Copy,GREEN—Applicant's Copy . . . i. .. . ., - , n . � � • • r 1 1 ' ' . .. . .� � � .i . . .�r�� .!/ ,o l�. � .�. ` .. . ' ' .. • • . .. ,n• .. . , � � " . . . . �� I�I�I�� ,j,. , , � �� u�s��-�o�� c�r�c�� ' � °,�� ' ��y�llUlN � . � � `�� Ulrv � � � � Uti�.J�JIr'l5l`�U t1�.vJl1v� � � . � ' U ts UNJ�� .. 0� � , . � , � I FLOOR JOIST � � ., , �SET BACK I , __ . FTGSlFORMS/STEEL � ' � ' ! FHA REC�MTS � ELECTRIC GROUND � � ' UNDER FLOOR DUCT -— ____— �_.___;......._.__. GR�UND PLUMBIN� UNDER FLOOR CUhIt�UIT �______ — - - - — ...._ . -- SLAB GRADE FIREPLACE FUUNDATICJN ' TEMP POWER FIREPLAGE'BOND BEAM J WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING Lj •Cp � _ ' 8 FT. BOND BEAM � ' FRAMINGNENTILIATIOfV FINAL BOND BEAIVI ROOF COVFR PRE-GRADING I ROUGH HEATING BENCHING RDUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING i FIMSH uRADING SHOWER/TUB TEST POOL ELECTRIC T EXT. LATH/SIDING POOL FENCING . � WALL INSULATION POOL FINAL � _�� _^ CEILING 1NSULATION � OFF SITE IMPS. _ ..�. DRYWALL NAILING � DEDICATIONS SEWER FINAL ENG. SEPTIC TANK lANDSCAPE/IRRIG. SEEP PITlL.L. �� t� ON SITE IMPS. G�S RiR TEST FINAL ZONING FINAt.COiJST. ' FIRE DEPT. FINAL Fl��ix�HEATING ' � HEALTH DEPT. FINAL �iNF�L ELECTRIC � DEV. FEES PAID ' t-s:��l1L PLUMBING ' ENERGY — - � � . ._...._...._..._ � _____ � � ---I--- : • �.r._� � � . � �• - "��.:�o�� _ � _�_ _� ___�_- -— ,' ,' i � �, ' �OfVIMENTS � - i , -------- --- SEPTIC TANK SIZE � . SEEP PIT/U SIZE -- � — ° _�__�__ __._ � '�. ��°�� ___ � _ ___ _ � . . � . ---